Provider Demographics
NPI:1760039556
Name:SHELTON, CARMELINA AURELIANA-MARIA (FNP)
Entity Type:Individual
Prefix:
First Name:CARMELINA
Middle Name:AURELIANA-MARIA
Last Name:SHELTON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3044 PRENTICE AVE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37914-5951
Mailing Address - Country:US
Mailing Address - Phone:865-200-9413
Mailing Address - Fax:
Practice Address - Street 1:2023 CLAY ST
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37917-4108
Practice Address - Country:US
Practice Address - Phone:865-201-7035
Practice Address - Fax:865-761-2726
Is Sole Proprietor?:No
Enumeration Date:2019-08-26
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000026163363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily